Liu Xi, Liu Zhonghan, Niu Yangyang, Zhang Kun, Zhang Xiaoqin, Yu Chen
Department of Nephrology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200092, People's Republic of China.
Department of Spinal Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200092, People's Republic of China.
J Multidiscip Healthc. 2024 May 1;17:2031-2038. doi: 10.2147/JMDH.S457193. eCollection 2024.
Patients on maintenance hemodialysis have an increased risk of fracture. However, the relationship between fracture and poor prognosis is not clear.
A total of 182 maintenance hemodialysis patients were enrolled in the study. The relationship between fracture and poor prognosis (cardiovascular events, stroke, malignancy and 5-year all-cause mortality) were analyzed.
21 of 182 patients had a history of fracture at the time of enrollment. 26 patients had a new fracture after enrollment. A total of 57 fractures occurred in 47 patients, the most common fracture site was the rib. Patients with fracture group had a higher proportion of elderly and female, higher serum phosphorus and B-type natriuretic peptide and lower hemoglobin, albumin, and potassium compared with those without fracture. Age (), hemoglobin (), and serum phosphorus () were the independent risk factors of new fractures in MHD patients. The incidence of malignancy and 5-year all-cause mortality in patients with fracture was higher than those without fracture (). But there was no significant difference in the incidence of acute myocardial infarction or stroke.
25.8% of maintenance hemodialysis patients had at least one fracture, with rib fractures accounting for the highest proportion. Age, hemoglobin and serum phosphorus were the independent risk factors of new fractures. The incidence of malignancy and 5-year all-cause mortality in patients with fracture was higher than those without fracture, but there was no significant difference in the incidence of acute myocardial infarction and stroke.
维持性血液透析患者骨折风险增加。然而，骨折与不良预后之间的关系尚不清楚。
本研究共纳入182例维持性血液透析患者。分析骨折与不良预后（心血管事件、中风、恶性肿瘤和5年全因死亡率）之间的关系。
182例患者中有21例在入组时已有骨折史。26例患者在入组后发生新发骨折。47例患者共发生57处骨折，最常见的骨折部位是肋骨。与无骨折患者相比，骨折组患者中老年人和女性比例更高，血清磷和B型利钠肽水平更高，而血红蛋白、白蛋白和钾水平更低。年龄（）、血红蛋白（）和血清磷（）是维持性血液透析患者新发骨折的独立危险因素。骨折患者的恶性肿瘤发生率和5年全因死亡率高于无骨折患者（）。但急性心肌梗死或中风的发生率无显著差异。
25.8%的维持性血液透析患者至少发生过一次骨折，其中肋骨骨折占比最高。年龄、血红蛋白和血清磷是新发骨折的独立危险因素。骨折患者的恶性肿瘤发生率和5年全因死亡率高于无骨折患者，但急性心肌梗死和中风的发生率无显著差异。
